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NPI Code Detail

MEDICARE: DIANE GENOVA NP

MEDICARE: DIANE GENOVA NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner106168CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700868247
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE GENOVA NP
Provider Business Mailing Address
First Line : 5920 MCINTYRE ST
Second Line : 300B
City : GOLDEN
State : CO
Zip : 80403-7445
Country : US
Telephone Number : 720-434-4876
Fax Number : 303-225-4246
Provider Business Practice Location Address
First Line : 5920 MCINTYRE ST
Second Line : STE 200
City : GOLDEN
State : CO
Zip : 80403-7445
Country : US
Telephone Number : 720-434-4876
Fax Number : 303-225-4246
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 04/12/2017

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